PW-13-2509NGV 0 6 2013
BY000000ee
Miami Shores Village
Public Works Department
10050 N.E. 2nd Avenue, Wiand Shores, Florida 33138
Tel: (305) 7952204 Fax (305) 756.8972
Public Works Perna NSLOI �LsDel
Permit Application
FBC 2004
POM*Tppe: POM Waft WATM
owners Name (Fee SROs Titi"dw) �a �G �(� /' Phone s: 3 > C�
Owners Address
cny A,41 S 4 ®r IPS E / 3 3 / 3 9 stagy Zhp 3 /3 F
T&MOLeaseeNeria Phone
.lob Address (wlate ffie work Is being dm) G of ---b 6;-
qty tidied Shores Viborg" County Miend Dads ZIP
is BuikUng Historically Designated: YES NO .
coma's Cornparw Naaas (� i� f °� l d l C� �/i� o� Plana S.
Contractors Address
Cw ale ZIP
sneers Name Of appHo") r� Phonef.
$ vekre of Work For tills Permit W Uneei. Foote or Work
Type of Wok ❑ Addition A ❑ N— ❑ Rewmwm❑
Dermomion
Descfte work: C c. -r A it P.e C'1ci,i ®ti ' 9,r 4-- 2," P cw*v 'T'rG,A
Submittal Fee S
Notary $
Scanning S
Code Erdorrt S
Total Fee Now Due $
(Continued on opposite side)
Fees
Pemdt Fee $ =F$ CO=
TratainglEducation Fee $ Technology Fee i
Radon $ Zoning Bond $
Structural Plan Review $
Bonding Compan}fs Name (ti aPPifcable)
Bonding.Compa" Address
City I State
WA
Mortgage Lender's Name (if applicable) WA
Mortgage Lender's Address
u10
State
4
Application is hereby made to obtain a permit to do the work and installations as indicated. I cardTy #0 no work or Instaliatim tum
commenced prior to the Issuance of a permit and that all work will be performed to meet the standards of all laws regulating cm#WdlGn In
this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC ....
OWNER'S AFFIDAVIT: I certify that all the foregoing information Is accurate and that all work will be done Is compliance with afi applicable
laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LOWER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant As a mzffNon to Nis Issuance of it Pubpc Works permit WM an estimated vele exoemfhrg $28)0, OR 81*11 nt must
pmn&e in good ft" a Dopy of ffm notice of commereement arW oairsbucUon San law bAx*m wNbe red ib Me person whose
piny is subject b aftedu rent. Alm, a ce►NBed copy of Me recorded nofioe ofcommerx:errrmrt mast be posted at Me alfa for ft brat
hr r► ~ occurs seven (7) days afterfhe buf<dfog permit Is issued /n Nle absence of amh posted noffba,fire brspeclb7 wN n& be
approved and a rehmpecbon fee wN be charged
Signature
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this-A2—
day
he `2
day of 20`, by day of d , 20_ , by.
who is personally known to me or wtio has produced Who Is personally know to me or has produced
as Identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My Commission Expires:
APPLICATION APPROVED BY:
11/17/2005
as identillication and who .44 pn oath.
AC6,.-J0 S.
My Commission Expires:
e TIN
Public Works Director or
his designee.
FPL POLE
N
New 2" PVC Conduit
Rigid polyvinyl chloride conduit,
Type PVC, buried in compliance
with Column 3 of Table 300.5
Buried in earth at a depth not less
than 18 in.
120'
1-11011se
Fence
0
" ' "F"z
ANTONIO SAY
My COMMISSION #FF052893
.............
EXPIRES September 10. 2017
,,407) 39"153 FloridallotMServiCO-COM
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ANTONIO SAY
My COMMISSION #FF052893
.............
EXPIRES September 10. 2017
,,407) 39"153 FloridallotMServiCO-COM
eg�100�f
1p-"
Lesserdepth If installed
below 2 -In. concrete pad (112 In.),
/-- Goncreie Pad
18 in. nlin.
(clirect burlall
PVC conduit and fittings directly buried
In earth at a depth not few 1han 18 In.
Wiremaster
Electric
12201 SW 128th
Court, Suite 101
Miami, FL 33106
Job Location
225 NE 96th ST,
Miami Shores FL
33138
mi
CA
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r
th
Lesserdepth If installed
below 2 -In. concrete pad (112 In.),
/-- Goncreie Pad
18 in. nlin.
(clirect burlall
PVC conduit and fittings directly buried
In earth at a depth not few 1han 18 In.
Wiremaster
Electric
12201 SW 128th
Court, Suite 101
Miami, FL 33106
Job Location
225 NE 96th ST,
Miami Shores FL
33138
jor,
OCT
JOHN LABRA & ASSOCIATE§j, INP.
Professional Land Surveyors & Mappers
777 N.W. 72nd AVENUE SUITE 3026, MIAMI, FLORIDA 33126
TELEPHONE: (308) 262.0400 1 FAX: (308) 262-0401
_—_ ..IBARRALANOSURVEYORS.COM
MAP OF BOUNDARY SURVEY
I I AT: 225 NE 96 STREET MIAMI SHORES. FL 33136
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IV ASPHALT PVMT. 15'A EYWAY h
F N D 75,00' .. o F.N.D.
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W.F.
LOT- 15
BLOCK . 30
ONE STORY
RFS. # 225
PL. e
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BLOCK - 30
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WATER - 1 I BLOCK -1
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PUMP
LEGAL DESCRIPTION.-
LOT 15 AND THE WEST 1n OF LOT 16, BLOCK 30, AMENDED PLAT OF MIAMI SHORES
SECTION ONE, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
10. PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
CERTIFICA770N:
RODRIGO MERA AND ADRIANA MERG
DRAWN BY: D.A.
DATE DRAWN: 08/06/2012
FIELD DATE: 08)MO12
CHECKED BY: C.M.I.
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STATE AND COMY MAA AND RMULAT10NS
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STATE OF
LEGAL DESCRIPTION.-
LOT 15 AND THE WEST 1n OF LOT 16, BLOCK 30, AMENDED PLAT OF MIAMI SHORES
SECTION ONE, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
10. PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
CERTIFICA770N:
RODRIGO MERA AND ADRIANA MERG
DRAWN BY: D.A.
DATE DRAWN: 08/06/2012
FIELD DATE: 08)MO12
CHECKED BY: C.M.I.
SCALE: 1'=201
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L.B.S 7806 SEA
INAKI SAIZARBITORIA, ESQ., P.A
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY, ATFS
NAVY FEDERAL CREDIT UNION
JOB NO: 12�2'J10 1
SHEET. 120F2